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Lingwang An,1 Kuei-Chun Yeh,1 Yunxia Liu,1 Dandan Wang,1 Xianglan Li,1 Qi Tang,1 Juming Lu1,2 1Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, 100079, People’s Republic of China; 2Department of Endocrinology, The General Hospital of the People’s Liberation Army, Beijing, 100853, People’s Republic of ChinaCorrespondence: Juming Lu, Department of Endocrinology, The General Hospital of the People’s Liberation Army, No. 28 of Fuxing Road, Haidian District, Beijing, 100853, People’s Republic of China, Tel +86 10 8822 9999, Email lujuming_jm@126.comObjective: We explore the effect of a structured online DSMES program on glycaemic control and the self-management behaviour of adolescents and young adults with T1DM.Methods: We used a pre–post uncontrolled intervention design over a period of 6 months. A total of 37 youths with T1DM aged 10– 45 years were enrolled. The intervention comprised 11 structured online DSMES course sessions; these were video-based and delivered by a diabetes specialist, nurses and a dietitian. The primary outcome was a change in (glycated hemoglobin) HbA1c. The secondary outcomes were changes in hypoglycaemia frequency, time in target range (TIR) among patients using a continuous glucose monitoring (CGM) system and self-management behaviour; the latter was measured using a T1DM self-management scale for Chinese adults (SMOD-CA) and the Chinese version of the diabetic behaviour rating scale in adolescents with T1DM (DBRS).Results: Twenty-three (85.2%) participants attended ≥ 8 of the online sessions. There was a significant reduction in HbA1c (from 6.92% to 6.47%, P = 0.002), hypoglycaemic episodes (from 6.0 to 4.0 during the preceding month, P = 0.026) and a significant increase in TIR (from 74.0% to 80.5%, P = 0.027) and an increase in the SMOD-CA score (from 79.6 to 84.6, P = 0.026) in young adults. No significant change in glucose control, hypoglycaemic events or DBRS score were found among children and adolescents. The score of the 12-item version of the Barrett–Lennard Relationship Inventory (B-L RI:mini) indicated that more than half of the participants experienced congruence, positive regard, and an empathic understanding in this programme.Conclusion: The online structured DSMES programme was effective in improving the glycaemic control and self-management behaviour of young adults with T1DM; however, integrating offline visits or appointments with online consultations may be necessary for youth patients.Keywords: children and adolescents, youth, type 1 diabetes, structured diabetes self-management education and support, online |
